The specific objectives of this application are to: (1) create a clinical research network of emergency medicine physicians, neurologists, and neurosurgeons that will work together to develop in an efficient manner more and better treatments for patients with acute neurological disorders through execution of NINDS-sponsored clinical trials. And (2) conduct two large, streamlined phase III clinical trials involving neurological emergencies to demonstrate the capability of the Network and to stimulate general interest in the NETT Network regarding future collaborations. We have brought together an interdisciplinary group expert in clinical trials management and neurologic emergencies from the robust expertise available at the University of Maryland and the Johns Hopkins University and have created a partnership with 9 community hospitals in rural, urban, and suburban settings. Our Clinical Site (consortium) Hub (CSH) leadership includes a neurologist and 3 emergency medicine physicians. Representation in the CSH includes experts in epilepsy, adult and pediatric trauma medicine, stroke, neurosurgery, neurointensive care, Neuroradiology, physiatry, and pediatrics. In the future, depending on the clinical trials in progress, representation in the CSH can vary as to the experts involved and relative effort on behalf of network activities. The CSH leadership will also work closely with the Maryland Institute for Emergency Medical Services Systems (MIEMSS) to effect pre-hospital protocols, as needed for the clinical trials to be conducted. The CSH is partnering with emergency medicine spoke principal investigators. The CSH leadership will support the hub and spoke research teams in their patient recruitment and management efforts as well as for their administrative needs. Communication amongst the hubs and spokes of our network will be promoted using a variety of methods, including efforts to fully utilize the internet and related broadband technologies. CSH leadership will work diligently to complement the activities of the NETT Network leadership to create a State of Maryland emergency research enterprise that will contribute to the objectives and success of the NETT Network and benefit our clinical trial patients. Ultimately the delivery of day to day emergent neurological care throughout the State will be enhanced and the lessons learned from the NETT Network research enterprise may benefit the delivery of emergency care statewide.